CDC: Prescription Drug Use Continues to Increase: U.S. Prescription Drug Data for 2007-2008

Key findings
Over the last 10 years, the percentage of Americans who took at
least one prescription drug in the past month increased from 44% to
48%. The use of two or more drugs increased from 25% to 31%. The
use of five or more drugs increased from 6% to 11%.
In 2007-2008, 1 out of every 5 children and 9 out of 10 older
Americans reported using at least one prescription drug in the past
month.
Those who were without a regular place for health care, health
insurance, or prescription drug benefit had less prescription drug
use compared with those who had these benefits.
The most commonly used types of drugs included: asthma medicines
for children, central nervous system stimulants for adolescents,
antidepressants for middle-aged adults, and cholesterol lowering
drugs for older Americans.

ATLANTA, Sept. 3, 2010-In the United States, spending for
prescription drugs was $234.1 billion in 2008, which was more than
double what was spent in 1999 (1). As new drugs are introduced and
new uses for old drugs are found, more patients can have improved
health and quality of life with the appropriate use of prescription
drugs. Current prescription drug use patterns need to be better
understood. This report provides an overview of current
prescription drug use in the United States, how many and what kinds
of drugs are currently being prescribed, and who receives them.

What are the trends in prescription drug use in the United
States over the past 10 years?
Prescription drug use in the United States increased from 1999-2000
through 2007-2008 (Figure 1).

The percentage of Americans who used at least one prescription
drug in the past month increased from 44% in 1999-2000 to 48% in
2007-2008.
The percentage of persons who used two or more prescription drugs
increased from 25% in 1999-2000 to 31% in 2007-2008.
The percentage of persons who used five or more prescription drugs
increased from 6% in 1999-2000 to 11% in 2007-2008.

What percentage of Americans used multiple prescription drugs in
the past month and how did this vary by age?
The use of multiple prescription drugs in the past month varied by
age (Figure 2).

Among children (under age 12), less than 10% used two or more
prescription drugs in the past month and only 1% used five or
more.
Among older Americans (aged 60 and over), more than 76% used two or
more prescription drugs and 37% used five or more.

Did prescription drug use vary among demographic subgroups?
There were differences in prescription drug use by age, sex, and
race and ethnicity (Figure 3).

Prescription drug use increased with age.
Women were more likely to use prescription drugs than men.
The non-Hispanic white population had the highest prescription drug
use and the Mexican-American population had the lowest.

What is the relationship between access to health care services
and prescription drug use?
Having a regular source of health care, health insurance, and
health insurance with prescription drug benefits were all
associated with increased use of prescribed medicines (Figure
4).

Persons with a regular place for health care were 2.7 times as
likely to have used prescription drugs in the past month as those
without a regular place for health care.
Those with health insurance were almost twice as likely to have
used at least one prescription drug in the past month as those
without health insurance coverage.
Among people with health insurance, those having a prescription
drug benefit were 22% more likely to use prescription drugs than
those who did not have this benefit.

What were the most frequently used types of prescription
drugs?
The types of prescription drugs used by Americans varied by age
(Figure 5).

The most commonly used types of prescription drugs in the
United States by age were:

Bronchodilators for children aged 0-11.
Central nervous system stimulants for adolescents aged 12-19.
Antidepressants for adults aged 20-59.
Cholesterol lowering drugs for adults aged 60 and over.
Among children under age 6, penicillin antibiotics were the most
frequently used prescription drugs.

Diuretics and β-blockers were also very commonly used
drugs in adults and older Americans. These are usually used to
treat high blood pressure and heart problems.

Summary
Over the last decade the percentage of Americans who took at least
one prescription drug in the past month increased by 10%. The use
of multiple prescription drugs increased by 20% and the use of five
or more drugs increased by 70%. By 2007-2008, one-half of Americans
used at least one or more prescription drugs; and 1 out of 10 used
five or more. One out of every five children used at least one or
more prescription drugs compared with 9 of every 10 adults aged 60
and over. Women were more likely to use prescription drugs than
were men. Those who were without a regular place for health care,
health insurance, or prescription drug benefit were less likely to
have used prescription medication compared with their
counterparts.

The types of prescription drugs that were most commonly used
were asthma medicines for children, central nervous system
stimulants for adolescents, antidepressants for middle-aged adults,
and cholesterol lowering and high blood pressure drugs for older
Americans. These patterns reflect the main chronic diseases common
at these ages, but may also likely reflect more aggressive
treatments for chronic medical conditions such as high cholesterol
and high blood pressure as recommended in the updated clinical
guidelines (2,3).

Those without a regular place for health care, health
insurance, or prescription drug benefits had lower prescription
drug use rates. Lack of access to medicines may impact health and
quality of life, as prescription drugs are essential to treat acute
and chronic diseases.

Finally, almost 40% of older Americans used five or more
prescription drugs in the past month. This likely reflects the need
to treat the many diseases that commonly occur in this age group;
however, excessive prescribing or polypharmacy is also an
acknowledged safety risk for older Americans, and a continuing
challenge that may contribute to adverse drug events, medication
compliance issues, and increased health care costs (4-6).

Definitions
Prescription drug use: National Health and Nutrition Examination
Survey (NHANES) participants were asked if they had taken a
prescription drug in the past month. Those who answered
“yes” were asked to show the interviewer the medication
containers of all prescription drugs. For each drug reported, the
interviewer recorded the product’s complete name from the
container (7).

Therapeutic drug class (type of drugs): Prescription drugs were
classified based on the three-level nested therapeutic
classification scheme of Cerner Multum’s Lexicon. Up to four
classes were assigned to each drug. The most commonly cited second
level of drug categorical codes were used in this analysis
(7).

Health care access: Based on the question, “Is there a
place you usually go when you are sick or you need advice about
your health?”

Health insurance coverage: Based on the question, “Are
you covered by health insurance or some other kind of health care
plan?”

Prescription drug benefit: Based on the question, “Do any
of these plans cover any part of cost of prescriptions?”

Data source and methods
NHANES data were used for these analyses (7). NHANES is designed to
monitor the health and nutritional status of the civilian
noninstitutionalized U.S. population. NHANES is nationally
representative. Sample weights, accounting for the differential
probabilities of selection, nonresponse, and noncoverage were used
for analyses. Variance estimates accounted for the complex survey
design using Taylor series linearization. Apart from age-specific
estimates, all estimates were age adjusted to the 2000 U.S.
standard population using four age groups: under age 12, 12-19,
20-59, and 60 and over (8). Trends were tested to evaluate changes
in estimates across survey periods and age groups. Differences
among groups were evaluated using a univariate t statistic. All
significance tests were two-sided using p < 0.05 as the level of
statistical significance. For comparison of estimates by race and
ethnic groups, adjustments for multiple comparisons were made using
the Bonferroni method (9). Reported differences are statistically
significant unless otherwise indicated. Statistical analyses were
conducted using SAS version 9.2 (SAS Institute, Cary, N.C.) and
SUDAAN version 10.0 (Research Triangle Institute, Research Triangle
Park, N.C.).

About the authors
Qiuping Gu, Charles F. Dillon, and Vicki L. Burt are with the
Centers for Disease Control and Prevention’s National Center
for Health Statistics, Division of Health and Nutrition Examination
Surveys.

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